Provider Demographics
NPI:1205166428
Name:DAO, UYEN-MINH T
Entity type:Individual
Prefix:
First Name:UYEN-MINH
Middle Name:T
Last Name:DAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 S CRISMON RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-2597
Mailing Address - Country:US
Mailing Address - Phone:480-358-9642
Mailing Address - Fax:480-380-0705
Practice Address - Street 1:1158 S CRISMON RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-2597
Practice Address - Country:US
Practice Address - Phone:480-358-9642
Practice Address - Fax:480-380-0705
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist